Clinicians used to rely on heavy, outdated books. Flipping through page after page, searching for the right answers took up a lot of valuable time. Now you have a plethora of mobile and online tools that help you get the latest information within minutes. You can now provide safer, more complete care to your patients.

Keep reading to discover new tools from Epocrates, plus "Then & Now" stories from the Epocrates Medical Information team. Do you have a "Then & Now" story too? We want to hear it! Tell us via Facebook, Twitter, or youropinion@epocrates.com.

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Writing My First Prescription

Anne Meneghetti, MD
Director, Clinical Communications, Epocrates

Morning rounds had just ended on the first day of my internship. A nurse breezed by and informed me that one of my patients needed an acetaminophen order for his headache. All the arrogance of my medical student self suddenly evaporated. I felt the weight of responsibility in my first act as a real physician: signing my name to a prescription.

"Be thorough," I told myself. I hunted down the giant drug reference book and thumbed through its nearly transparent pages for contraindications, safety, and dosing. I scoured the patient's chart for allergies, problem lists, LFTs and more. Painstakingly, I compared his active meds with a long list of potential drug interactions. What if it's not just a simple headache? What if an analgesic masks a key symptom crucial to diagnosing a life-threatening condition? I checked with my resident and finally signed the order.

This summer's new interns will likely feel that same sense of responsibility as they write their first orders. Yet, this generation is lucky to have access to modern electronic decision support tools. Epocrates Rx® offers easy, mobile access to more answers than I could’ve dreamed about back in my youth. The concept of pressing a single button to reveal multiple drug-drug interactions between dozens of medications at once – that alone is amazing. We've come a long way since the "peripheral brain:" mine was a pocket-sized black notebook bulging with tables, tips, mnemonics, and ACLS protocols.

Doctor of Pharmacy students often rounded with us on the wards, like guardian angels ensuring that we trainees were properly dosing each medication. Decades later, a friend from med school suggested I consider working at Epocrates. When I joined the company in 2006, I was amazed to discover that Epocrates Editor-in-Chief Susan Comes was one of those very PharmD students who rounded with me on the wards. At least one thing has not changed for both of us – we, along with a team of clinicians here at Epocrates, are still working hard to promote safe prescribing. We still feel that weight of responsibility in providing information designed for use in patient care.

Visit our new FDA Reporting Resource online to explore how, when, and why clinicians report adverse events to the FDA. Your report could make the difference to improving safety for all.

In addition, we now provide a quick reference list "FDA Adverse Event Reporting" under "Tables" within Epocrates mobile products or Epocrates® Online Premium.

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HIV Mobile Resource Center

The HIV Mobile Resource Center is a FREE tool from Epocrates for your iPhone, Palm®, or Windows Mobile® device. This resource features articles that are carefully selected and commented on by Contributing Editor Paul E. Sax, MD, Clinical Director of the Division of Infectious Diseases and the HIV Program at Brigham and Women's Hospital and an Associate Professor of Medicine at Harvard Medical School in Boston, Massachusetts. Content is updated every 2 weeks and includes clinical news, conference highlights, resources, and scientific abstracts.

A: Start by selecting the Rx lookup on your iPhone or BlackBerry, the Rx tab on Palm or Windows Mobile, or the Drugs tab at Epocrates Online. You will see the option to change between formularies you have loaded on your device or account. Select your patient's formulary before you look up a drug. If the drug isn't covered, it's no problem. You can tap or click on the formulary link to get to a list of alternatives or you can browse by drug class to see which drugs are covered at what levels. Have you started contracting with a new payer? Simply log into your Epocrates account online to add or delete formularies for free. If you don't see your patient's prescription plan there, let us know at formularyfeedback@epocrates.com, so we can work with them to get it added.

As you can see, we have come a long way since the "old days" of prescribing on formulary. After you had decided what type of drug you wanted to prescribe for your patient, you would go to your library of tattered formulary books, only to find that the one you needed at that moment was missing. Foiled again by the front office staff! Upon finally tracking it down and looking up several drugs to find one appearing to be covered, you wrote the prescription and then crossed your fingers, hoping that the formulary hadn't changed since the book was printed nearly a year prior and that the pharmacy wouldn't be paging you at your daughter's dance recital to change the drug. That was a mere 10 years ago. Luckily, times have changed.